What is an undescended testicle?

While a baby boy is developing in the womb, the tissue that becomes the testicles starts to develop in the belly, just below the kidneys. Normally, as the baby develops, the testicles move down a canal into the scrotum. The scrotum is the sac that holds the testicles. If a testicle does not move down into the scrotum, it is called an undescended testicle.

Undescended testicles occur in about 3% of full-term baby boys. They are more common in premature babies.

An undescended testicle can make it harder for a man to have a child. The exact cause for this infertility problem is not known, but it is most likely due to the high temperature in the belly, which affects the ability of the testicle to make sperm. It is not known if treatment before your child is 6 months old helps to improve fertility when he is older.

Boys who have had an undescended testicle have an increased risk of hernias or urinary tract problems. Men who have had an undescended testicle have a much higher risk of testicular cancer. Treatment of an undescended testicle does not lower the risk of cancer but allows earlier detection by physical exam.

What is the cause?

The causes are complex and not the same for every boy. It can be caused by problems with hormones or developing tissue. A specialist in urology can tell you more about the cause of your child’s condition.

Sometimes, one or both testicles are not there at all. This can happen if there was a problem with the blood supply to the testicle while the baby was developing and the testicle never formed.

How is it diagnosed?

Your healthcare provider will examine your child. If your provider cannot feel both testicles in the scrotum, your child will have tests to find the missing testicle. Different tests can be done, such as:

• Ultrasound scan, which passes sound waves and their echoes through the body from a small device that is held against the skin to create pictures of organs inside the belly or pelvis
• Computed tomography (CT) scan, which is a series of X-rays taken from different angles and arranged by a computer to show thin cross sections of parts of the body
• Magnetic resonance imaging (MRI), which uses a powerful magnetic field and radio waves to take pictures from different angles to show thin cross sections of parts of the body

Sometimes, surgery may be done to find the undescended testicle if it cannot be found with these scans. The surgical procedure is called a laparoscopy. It uses a lighted tube with a camera put through a cut near the bellybutton to look inside the pelvis.

How is it treated?

Most undescended testicles continue their normal descent after birth and do not need treatment. Usually the testicles move into place naturally by the time a boy is 6 months old. If a testicle hasn’t descended after 6 months, it is unlikely that it will descend on its own.

If your child is older than 6 months and has an undescended testicle, your healthcare provider will refer you to a specialist called a urologist for treatment. Two types of treatment can help the testicle go to its normal place in the scrotum.

• Surgery is advised when the testicle has not descended very far.
• Hormone therapy may be best if the testicle has descended part way but is not yet out of the belly.

How can I take care of my child?

Your child should see a urologist as soon as the problem is diagnosed. Early treatment will improve your child’s chances of being able to make sperm and have children when he is an adult.